Surgical Patient

Pain Perception

*pain receptors record the sensation

*sensation is sent by the spinal nerves to the spinal cord and then to
the brain

*sensation is received and interpretedin the brain

Anesthesia-is given to prevent pain, to relax the muscles, and to

induce forgetfulness

2 TYPES Anesthesia:

1. General Anesthetics-these include the pt to become unconcious

2. Local Anesthetics-these include loss of feeling in a specific area

General Anesthetics

Blocks reception of pain in the brain.

Given 2 ways

1. Inhalation-some gases that are used as anesthetics include

nitrous oxide and cyclopropane

-inhalation anesthetics are apt to make the pt secrete more mucous

and to experience

nausea

-special attention must be given after surgey to keep the

respiratorry tract clear,

-there is a real danger that the pt may aspirate ( INHALE ) vomitus

into the respiratory tract

2. Intravenous-drugs are induced directly into the veins

-these drugs, such as sodium pentathol, act rapidly.

-the pt quickly loses conciousness

-IV anesthetics are often used with other types of anesthesia for
short operations

Local Anesthetics-act by
1. Blocking pain receptors in the oiperative area

-drugs such as procaine hydrochloride may be injected into the pt

around the operative area

-these drugs stop the sensation of pain only in that area

-the pt remains awake but free from pain during the operation

2. Blocking transmission of the pain sensation at the level of the

spinal cord.

-a drug injected into the spinal cord prevents feeling in any point
below the level of injection

-the pt remains awake

-this type of anesthesia is commonly used for abdominal surgey

because it produces good relaxation to the muscles

-this technique is called SPINAL ANESTHESIA

Surgical Care

Perioperative- care of surgical pt

3 Parts Divided into

1. Preoperative ( before surgery )

2. Operative (in the operating room )

3. Postoperative ( after surgery )

Preoperative Care

-this begins when surgery is planned by the physician with the pt.
Your responsibilities begin when the pt is admitted to facility. may
answer general questions that pt may ask, but you must refer
specific questions about the surgery, its possible outcome,and
anesthesia to the nurse.

-uring preoperative period the nurse will determine the pt's specific
needs. Nurse also does preoperative teaching.

Psychological Preparation: All members of the health care team

need to be sensitive and responsive to the psycological needs of the
pt. You will be in frequent contact with the pt, you may be the first
to recognize sighns of fear or concern. Listen to what they say and
observe the body languageof pt carefully. Report observations to
nurse so appropriate nursing intervention can be carried out.

Build pt confidence by:

a. Performing your work in an efficient, calm manner

b. Being available to listen

c. Explaining what you plan to do before carrying out any procedure

d. Encouraging the pt to participate in his own care as much as

possible. This helps the pt feel that he still has a measure of control
over his life.

e. Immediately transmitting requests for clergy visits.

Physical Preperation: THE EVENING BEFORE SURGERY:

SURGICAL PREPARATION MAY INCLUDE

-bath or shower